The Gallbladder: Problems, Treatment, Removal, and Diet

Sep 16, 2019 | General Medical, Liver Disease

Like the humble spleen, your gallbladder goes about its business unnoticed for most of your life. When it is healthy, this four-inch long organ hides under your liver doing its job without causing a fuss—or giving a warning that something might be wrong. All this changes the moment a gallbladder attack strikes. These attacks can be extremely painful, and complications can be life-threatening.

What is the Gallbladder?

Tucked in the upper right section of your abdomen, your gallbladder is a small, pear-shaped organ that stores bile which you use to digest fat. The gallbladder is also responsible for helping your body absorb vitamins and minerals that are fat-soluble and might otherwise go undigested. The bile is transported from the gallbladder to the common bile duct, and onward into the small intestine.  

Linked to the pancreas and liver, your gallbladder is one of the organs that provides a vital service in properly digesting what you eat and drink. As with inflammation of the pancreas, problems with your gallbladder can result in intense pain, and can even require hospitalization. You can live without your gallbladder, but like your pancreas, your gallbladder rupture can be life threatening. For this reason, your doctor may recommend removing your gallbladder if you have chronic problems such as recurring inflammation or gallstones.

What are the most common gallbladder problems?

Many different things can cause pain in the gallbladder. Most conditions eventually boil down to one of two causes. One is a blockage of some sort that is obstructing the flow of bile, and the other is inflammation or irritation to the gallbladder itself or the surrounding tissue. 

Blockages in the gallbladder are caused by gallstones or gallstone sludge. These crystals, which can range in size from a golf ball to a grain of sand, can lead to blockage of the bile duct, preventing your gallbladder from emptying properly. These stones can come from a few different sources. Regardless of the source, gallstones or gallstone sludge can block the biliary duct or neck of the gallbladder. This results in a gallbladder attack, also known as biliary colic. Severe pain, yellowing of the skin (jaundice), fever, dark urine, and vomiting are all common symptoms of gallbladder disease.

Like your pancreas, it is possible for your gallbladder to rupture, leading to a deadly infection. If you are experiencing pain in the abdomen so severe that it is impossible to find a comfortable position to rest, or if you are vomiting and running a high fever, seek medical attention immediately, as a ruptured gallbladder can lead to life-threatening infection.

Blockages in the Gallbladder

If your liver is excreting high levels of cholesterol, your gallbladder may not be able to dissolve all of it properly. This excess cholesterol can form into small crystals and eventually into stones. These are typically the most common form of gallstones and are identified by their yellowish color. 

Similarly, if your liver is producing too much bilirubin, which is sometimes the case if you have cirrhosis or certain blood disorders, you will also be at a higher risk of forming stones in your gallbladder. An excess of bilirubin, which is less common than high cholesterol, will result in black or dark-brown stones. 

Even the bile in the gallbladder itself can become a problem if it is not emptying correctly, leading to an abnormally high concentration of bile. For people with chronic gallstone formation, determining whether the gallbladder is emptying correctly is something that will need to be investigated. 

Regardless of the source of the stone, any form of blockage associated with the gallbladder will soon become a problem. Blockages in the neck of the gallbladder can often result in a form of inflammation known as cholecystitis. This inflammation can cause debilitating pain and you may develop a fever. 

Gallstones can affect more than just the function of your gallbladder. The pancreas supplies pancreatic juices to the small intestine through the pancreatic duct, but this tube joins the common bile duct before emptying into your intestines. If a stone from the gallbladder blocks the pancreatic duct, your pancreas can become inflamed, leading to severe, unrelenting pain. This pain, known as pancreatitis, typically requires hospitalization. 

Gallbladder Cancer

There are definitely things that can go wrong with your gallbladder, but thankfully cancer is not a common concern. Less than 4,000 cases of gallbladder cancer are reported in the United States each year. The rarity of gallbladder cancer does not mean it is any less dangerous than other forms of cancer, though. It is still possible for cancer in the gallbladder to metastasize and spread to other parts of the body. 

Perforated Gallbladder

Inflammation of the gallbladder (cholecystitis) is extraordinarily painful, but there are cases when this pain is an indicator of something more serious. It is possible for the gallbladder to rupture in a condition known as a gallbladder perforation. Known as acute cholecystitis is a life-threatening condition. Perforation of the gallbladder can cause a generalized infection of the abdomen called sepsis. Sepsis is a deadly condition if left untreated can lead to a host of other conditions like pneumonia and acute renal failure. 

Perforation of the gallbladder is particularly problematic as it is very difficult to diagnose. It can be a challenge for your doctor to know the full extent of your gallbladder problems, as even mild cholecystitis can cause pain severe enough to require medical attention. In most cases, acute cholecystitis can only be confirmed by visual inspection during abdominal surgery. As most doctors are reluctant to perform surgery unless there is a very good reason to do so, acute cholecystitis often goes undiagnosed until complications develop. If you are experiencing the symptoms of a gallbladder attack, call 911 or seek medical attention immediately. to ensure you don’t waste any time getting the help you need.

Dysfunctional Gallbladder, Chronic Gallbladder Disease, and Other Conditions

The gallbladder is no different than any other part of the body when it comes to prolonged damage. Ongoing inflammation can cause scarring and contribute to several different problems with your gallbladder.

Chronic gallbladder disease is a term used when a series of gallbladder attacks happen repeatedly over time. These attacks each cause damage to the gallbladder, and the repeated inflammation and irritation can eventually lead to scarring and tissue damage. For this reason, repeated instances of gallstones blocking the flow of bile should not be left untreated. 

Unlike blockages, biliary dyskinesia is a different sort of problem that is sometimes linked to your gallbladder being damaged. If you have this condition, your gallbladder will function at lower levels than normal. If you experience pain in the upper abdomen, bloating and nausea after eating a fatty meal, you may have biliary dyskinesia. While this condition can cause intense abdominal pain, there are no stones in the gallbladder.

Another problem that can arise from ongoing inflammation in the gallbladder is sclerosing cholangitis. The cause of this condition is not known for certain, though it is likely that chronic inflammation of the gallbladder can contribute. The upper abdominal pain associated with other forms of gallbladder dysfunction is also a symptom of sclerosing cholangitis, as are jaundice and fever. There is a greater danger with this disease, though, as it can increase your risk of liver cancer. Sclerosing cholangitis is also a high-risk factor associated with ulcerative colitis. 

Gallbladder Removal

Gallstones or other issues of the gallbladder are treatable, but there are occasions when your doctor will recommend removing your gallbladder altogether. This is usually the case when chronic gallstones or inflammation and infection have become so severe that other forms of treatment no longer prove effective. 

Thankfully, you can live well without your gallbladder. In fact, many people do. Gallbladder removal surgery is one of the most commonly performed abdominal surgeries in America. Like any other part of the body, though, if you lose your gallbladder, you will have to make changes to your diet and lifestyle to maintain good digestive health.

How to Prevent Gallstones

There is no known way to completely prevent gallstones. Some people, especially women, are at a higher risk of gallstones regardless of lifestyle and diet. Native and Mexican Americans, for example, are also statistically more likely to develop gallstones than some other people groups. 

Genetic links, regardless of ethnicity, can also make you more prone to gallstones. If your family has a history of gallbladder problems, you should take precautions and seek medical advice about modifying your diet and lifestyle to help lower your risk of gallstones. 

One of the risk factors for gallstone formation you may be able to address is obesity. This does not mean you should drop the pounds overnight, though. Extremely rapid weight loss can cause more problems than it solves in the short run as your body attempts to adapt to rapid changes.

The good news is, even if you are genetically predisposed to gallstones or other gallbladder issues, you can still lower the likelihood of developing cholecystitis by changing your diet. Like many other condition-specific diets, the basis of a gallbladder diet is going to be eating a variety of high-fiber foods and vegetables. Reducing your intake of carbohydrates and sugars will also help.

When to Talk to Your Doctor

Like other organs in the abdomen, it can be hard to tell exactly what is going wrong from a generalized set of common symptoms. Your doctor will likely begin with a series of blood tests, and possibly request a CT-scan or other imaging tests in an attempt to diagnose what is wrong.

Talk to your doctor immediately if you are experiencing debilitating pain in your abdomen. This is especially true if the pain is accompanied by a fever. A perforated or ruptured gallbladder can be difficult to diagnose, and if this has happened to you, every minute counts. If you are vomiting, experiencing sudden, intense pain in the abdomen, pain radiating into the upper back between the shoulder blades and right shoulder, and a fever, you should talk to your doctor immediately. Sepsis resulting from gallbladder perforation can lead to organ failure and death within a matter of days or hours, so seeking medical attention early could save your life.
Even if you aren’t up against a life-threatening gallbladder perforation, there are still plenty of good reasons to talk to your doctor.

If you have been experiencing chronic gallstone problems, make an appointment today with the Gastroenterology Consultants of Savannah. you may want to consider changing your diet and lifestyle to help accommodate your condition. Your doctor can be a great resource to help you get started down the path of preventing further gallstone problems.